This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Adjuvant taxanes and the development of breast cancer‐related arm lymphoedema. BJS 2015; 102: 1071-1078.

Published: 3rd June 2015

Authors: M. Cariati, S. K. Bains, M. R. Grootendorst, A. Suyoi, A. M. Peters, P. Mortimer et al.

Background

Despite affecting approximately one‐quarter of all patients undergoing axillary lymph node dissection, the pathophysiology of breast cancer‐related lymphoedema (BCRL) remains poorly understood. More extensive locoregional treatment and higher body mass index have long been identified as major risk factors. This study aimed to identify risk factors for BCRL with a specific focus on the potential impact of chemotherapy on the risk of BCRL.

Method

This was a retrospective analysis of a cohort of consecutive patients with breast cancer treated at a major London regional teaching hospital between 1 January 2010 and 31 December 2012. All patients had node‐positive disease and underwent axillary lymph node dissection. Data regarding tumour‐, patient‐ and treatment‐related characteristics were collected prospectively. The diagnosis of BCRL was based on both subjective and objective criteria. Multivariable Cox proportional hazards regression was used to assess the association between treatment and risk of BCRL.

Results

Some 27·1 per cent of all patients (74 of 273) developed BCRL over the study period. Administration of taxanes showed a strong association with the development of BCRL, as 52 (33·5 per cent) of 155 patients who received taxanes developed BCRL. Multivariable Cox regression analysis demonstrated that patients who received taxanes were nearly three times more likely to develop BCRL than patients who had no chemotherapy (hazard ratio 2·82, 95 per cent c.i. 1·31 to 6·06). No such increase was observed when taxanes were administered in the neoadjuvant setting.

Conclusion

The present findings suggest that adjuvant taxanes play a key role in the development of BCRL after surgery. This may support the use of taxanes in a neoadjuvant rather than adjuvant setting.

Full text

You may also be interested in

Original article

Population‐based study of the effect of preoperative breast MRI on the surgical management of ductal carcinoma in situ. BJS 2019; 106: 1488-1494.

Authors: K. B. I. M. Keymeulen, S. M. E. Geurts, M. B. I. Lobbes, E. M. Heuts, L. E. M. Duijm, L. F. S. Kooreman et al.

Original article

Nationwide population‐based study of the impact of immediate breast reconstruction after mastectomy on the timing of adjuvant chemotherapy.

Authors: E. Heeg, J. X. Harmeling, B. E. Becherer, P. J. Marang‐van de Mheen, M. T. F. D. Vrancken Peeters, M. A. M. Mureau et al.

Original article

International multidisciplinary expert panel consensus on breast reconstruction and radiotherapy. BJS 2019; 106: 1327-1340.

Authors: M. B. Nava, J. R. Benson, W. Audretsch, P. Blondeel, G. Catanuto, M. W. Clemens et al.

Original article

Prognostic impact of repeat sentinel lymph node biopsy in patients with ipsilateral breast tumour recurrence. BJS 2019; 106: 574-585.

Authors: I. G. M. Poodt, G. Vugts, R. J. Schipper, R. M. H. Roumen, H. J. T. Rutten, A. J. G. Maaskant‐Braat et al.

Notes: No impact

Original article

Effect of preoperative injection of superparamagnetic iron oxide particles on rates of sentinel lymph node dissection in women undergoing surgery for ductal carcinoma in situ (SentiNot study). BJS 2019; 106: 720-728.

Authors: A. Karakatsanis, A.‐F. Hersi, L. Pistiolis, R. Olofsson Bagge, P. M. Lykoudis, S. Eriksson et al.

Original article

Short‐term cost‐effectiveness of one‐stage implant‐based breast reconstruction with an acellular dermal matrix versus two‐stage expander‐implant reconstruction from a multicentre randomized clinical trial. BJS 2019; 106: 586-595.

Authors: V. L. Negenborn, J. M. Smit, R. E. G. Dikmans, H. A. H. Winters, J. W. R. Twisk, P. Q. Ruhé et al.

Original article

Autologous fat transplantation alters gene expression patterns related to inflammation and hypoxia in the irradiated human breast. BJS 2019; 106: 563-573.

Authors: A. Lindegren, I. Schultz, I. Sinha, L. Cheung, A. A. Khan, M. Tekle et al.

Notes: Effects on fibrosis after radiotherapy

Original article

Sentinel lymph node biopsy in microinvasive ductal carcinoma in situ. BJS 2019; 106: 375-383.

Authors: F. Magnoni, G. Massari, G. Santomauro, V. Bagnardi, E. Pagan, G. Peruzzotti et al.

Original article

Patient‐level costs in margin re‐excision for breast‐conserving surgery. BJS 2019; 106: 384-394.

Authors: Y. Grant, R. Al‐Khudairi, E. St John, M. Barschkett, D. Cunningham, R. Al‐Mufti et al.

Notes: Reoperations expensive

Systematic review

Meta‐analysis of sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with initial biopsy‐proven node‐positive breast cancer. BJS 2018; 105: 1541-1552.

Authors: S. R. Tee, L. A. Devane, D. Evoy, J. Rothwell, J. Geraghty, R. S. Prichard et al.

Notes: In selected patients using dual tracer

Original article

Feasibility study of combined dynamic imaging and lymphaticovenous anastomosis surgery for breast cancer‐related lymphoedema. BJS 2019; 106: 100-110.

Authors: A. A. Khan, I. Hernan, J. A. Adamthwaite, K. W. D. Ramsey

Notes: Effective in selected patients

Randomized clinical trial

INTEND II randomized clinical trial of intraoperative duct endoscopy in pathological nipple discharge. BJS 2018; 105: 1583-1590.

Authors: G. Gui, A. Agusti, D. Twelves, S. Tang, M. Kabir, C. Montgomery et al.

Notes: Identifies causative lesion